Citizen Report of Incident

2. This form SHOULD NOT be used for serious allegations or anything requiring an immediate response from law enforcement. 

   
   

   The use of this form is to report non-emergent issues only; for example, lost items (such as passports, ID cards or wallets) when there is no suspect information or to report missing property that was left behind at a hotel and needs to be reported for insurance purposes. 

   
   

   You will not receive immediate assistance by submitting this form. Please allow our department 48 hrs to respond. 

4. Reporting Person Information
6. Name*
7. Email Address
9. Address*
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Date of Birth
    Date of Birth
20. Incident Information
22. Type of Incident*

    1. Lost Property

    1. Damaged Property

    1. Other
24. If "other", please explain
26. Date of Incident*
    Date of Incident Start Date

    Date of Incident Start Time

    —

    Date of Incident End Date

    Date of Incident End Time
27. Location of Incident*
29. Please explain what happened*
33. Vehicle Information
35. Vehicle Make
36. Vehicle Model
37. Vehicle Year
39. Vehicle Color
40. License Plate Number
41. State of Registration
45. Property Information
47. Are you missing property?

    1. Yes
    2. No
48. Was your property damaged?

    1. Yes
    2. No
49. Do you have information about who may have taken or damaged your property?*

    1. Yes
    2. No
51. Please list all items of property that are missing or damaged*

    Include make/model/serial numbers if applicable.

    For passports or personal documentation, please include the country or state of issuance.

55. I certify that the above is true and correct to the best of my knowledge and understand that knowingly providing false information to Law Enforcement is a violation of Wisc. Statute 946.41. Furthermore, I gave no one permission to take or damage the above listed property.

57. Electronic signature of person reporting*
58. Date and time of submission*
    Date and time of submission

    Date and time of submission
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field